What to Expect During Your Treatment
Once you are diagnosed with cancer and determine that radiation is the best course of treatment for you, there are many steps to this process. It is natural to have questions about the process and we want our patients to feel comfortable with the decision they’ve made about their treatment. Depending on the type and stage of cancer, most patients typically come for radiation on a daily basis (Monday – Friday) for 5-9 weeks. Before starting treatment each patient will complete a series of appointments at the radiation center. It is our goal at The Austin Center for Radiation Oncology to make sure each patient feels comfortable in our office and confident in their course of treatment. The steps between your initial consultation in our office and the end of radiation treatment are as follows:
Step 1: The Consultation with the Radiation Oncologist
During the consultation appointment, your radiation oncologist will discuss treatment options based on your specific case. We encourage you to bring family members or significant others with you, as they may be able to help you during the process and have their own questions answered. The medical assistant will accompany you to a room to take your vital signs and record your history. The radiation oncologist will meet with you to discuss in detail radiation therapy, the reasons for recommending the treatment and the potential risks and side effects of such treatment. Ample time will be provided so that you have a full understanding of the treatment process and all your questions or concerns regarding your treatment options are answered in full. Once you feel that you have an understanding of the proposed treatment, risks, and side effects, you will be asked to sign a consent form. After you have signed the consent, your doctor is always available to answer new questions or provide additional information. You can withdraw your consent at any time for any reason.
Step 2: The CT Simulation
Once you decide radiation therapy is right for you, we will schedule you for a treatment planning session called a simulation, which is done here at the radiation center. If there are any special instructions prior to the scan we will give them to you. The radiation oncologist uses this CT scan to plan your treatment. The simulation will help determine how many treatments to give, the area to be treated, the beam arrangements and dose distribution to use for your treatment. Please allow one hour for this appointment.
Once you check in on your appointment day, the CT technician will take you to the CT room to set you up in the position you will be in for your treatments. A mold will be made using a special device called a vac-loc bag. The vac-loc is used to ensure exact positioning.
Next, the CT technician will scan you and mark your body with three tiny permanent tattoos. These tattoos are the size of a freckle. The tattoos are necessary so the radiation therapist can precisely set you up in the same position each day. Once the tattooing is complete, two photos are taken which will be used by the radiation therapists to simulate exact positioning for treatment.
When your simulation scan is complete, we will schedule a time and date for your treatments to begin. Your treatments will begin approximately one week from the time of your CT simulation. The radiation therapist will go over any special instructions with you and discuss what to expect when you come for your treatments.
Step 3: The Planning Process
After simulation, all details from the CT simulation procedure are sent over to the dosimetrist and physicist to determine the best treatment plan for you. These professionals perform highly technical calculations to measure the precision of your treatment plans, and calculate the best angles to treat your tumor, or tumor site. As part of the treatment planning, your medical team conducts extensive quality assurance testing with the treatment equipment to ensure that the planned treatment can be accurately carried out for each individual. The radiation oncologist reviews and approves all treatment plans to ensure your treatment is ready to begin.
Step 4: Treatment Delivery
Upon arrival, you will check in with the receptionist at the front desk and one of the radiation therapists will guide you through what to expect during your treatment. You may be asked to change into a pair of scrub pants or a gown each day and you will have a closet to secure your belongings during treatment. The therapist will bring you into the treatment room to set you up in the same position that was designed when you had your CT simulation scan. The customized body mold and skin marks will help us get you into position. All we ask is that you hold very still, breath normally, and relax. You will see green lasers coming out of the wall, these cross over your skin marks to help us ensure you are aligned properly. Once we have you set up on the reference skin marks, we will step out of the room to our console area where we control the radiation machine and watch and listen to you at all times on a closed intercom system and TV monitor. The entire treatment will last 15 – 30 minutes. You will not feel or see anything during your radiation treatments. You will just hear the machine make some buzzing noises. We provide calming music that plays for you during your treatment session and you are welcome to bring in your own CD from home.
At the Austin Center for Radiation Oncology we have a dedicated team of highly trained professionals that will work together to provide the care that is just right for each patient. The radiation therapy team will include the following:
Radiation Oncologist: This is your doctor who specializes in the use of radiation for treating cancer. The radiation oncologist reviews all pertinent medical information to determine the most successful course of treatment for each patient. Your doctor will also work with other physicians and health care providers in determining the right plan of treatment for you. Once a course of treatment has been determined, the radiation oncologist will prescribe and plan how your treatment will be given. Your radiation oncologist also tracks your progress and adjusts the treatment, as necessary, to make sure you receive the best care.
Radiation Therapist: Radiation therapists are highly skilled health care professionals who are integral members of the cancer care team. Radiation therapists use advanced computer systems to operate sophisticated radiation therapy equipment such as a Linear Accelerator. The radiation therapist works closely with the radiation oncologists, medical physicists and other members of the health care team. Since the course of radiation therapy can extend over several weeks, the radiation therapist is responsible for monitoring the condition of the patient and is required to assess if changes to the treatment plan are necessary. The therapist takes images of the targeted treatment area and reproduces the patient positioning and plan parameters daily.
Medical Physicist and Dosimetrist: The medical dosimetrist is responsible for designing a treatment plan and carrying out calculations for the delivery of radiation treatment based on the radiation oncologist’s prescribed course of treatment. This treatment plan takes into consideration tumor pathology, tumor volume, and inherent dose-limiting structures surrounding the tumor. The treatment plan and radiation field-placement techniques are constructed utilizing sophisticated computer equipment and technology. The medical dosimetrist, along with the radiation oncologist and medical physicist, will work together to construct a treatment plan that will meet the prescription written by the oncologist, ensuring minimal dose will affect healthy surrounding tissue. Once the treatment plan is complete, the medical dosimetrist will work closely with the radiation therapists in the implementation of the prescribed plan.
CT Technologist: Before you begin your radiation treatments, you will first have a CT scan performed by the CT technologist. This person utilizes computed tomography scans to produce cross-section images of your internal organs and tissues for your radiation therapy treatment plan. The CT tech will construct an immobilization device that is used for your daily treatment and will aid the therapists in reproducing your exact position for treatment daily. After the simulation the CT tech will go over your images with the radiation oncologist. Once the scan is approved, the images will be sent over electronically and enter the planning stage.
Medical Assistant: This individual assists the radiation oncologist in clinical duties in the radiation therapy center. He or she maintains medical records, billing, verification, and coding for insurance purposes. Some clinical duties that he or she performs includes taking and recording vital signs and medical histories, preparing patients for medical examination, drawing blood, and administering medication as prescribed by the radiation oncologist.
Patient Service Representative: This person will greet you when you arrive for your radiation appointments and is available to answer questions regarding billing, policies, and available services. He or she also files documentation and maintains a filing system for patient charts. This person will register you in our system by verifying that your record is up-to-date and accurate and makes appropriate changes in the computer system. They also will collect payment from you, apply the payments, and make necessary adjustments to your accounts in your chart.